Fusion of ultrasound and 3D single-photon-emission computed tomography/computed tomography to identify sentinel lymph nodes in vulvar cancer: feasibility study

Ultrasound Obstet Gynecol. 2019 Oct;54(4):545-551. doi: 10.1002/uog.20364. Epub 2019 Aug 31.

Abstract

Objective: To evaluate the feasibility of fusion of ultrasound imaging and three-dimensional (3D) single-photon-emission computed tomography/computed tomography (SPECT/CT) in detecting sentinel lymph nodes in women with vulvar cancer.

Methods: This was a prospective pilot single-center study. Patients with vulvar cancer who were candidates for sentinel lymph-node biopsy were enrolled between December 2018 and February 2019. Fusion imaging virtual navigation using 3D SPECT/CT and ultrasound was performed to investigate the tumor-draining lymph node. All clinical, imaging, surgical and histological information was collected prospectively and entered into a dedicated Excel file. Feasibility and success of fusion imaging virtual navigation and time needed to perform the three steps of fusion imaging were evaluated.

Results: Ten lymph-node sites were evaluated in five consecutive women with a histological diagnosis of vulvar cancer. Fusion imaging virtual navigation was feasible and completed successfully for all (10/10) draining sites. Median overall time to perform fusion imaging was 32 (range, 25-40) min and the time decreased from the first to the last examination.

Conclusions: The present study demonstrated that fusion imaging virtual navigation using 3D SPECT/CT and ultrasound is feasible and able to detect sentinel lymph nodes in women with vulvar carcinoma. Fusion imaging using ultrasound for detection of sentinel lymph nodes opens up multiple diagnostic and therapeutic opportunities in gynecological oncology. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

Keywords: SPECT/CT; fusion; sentinel lymph node; ultrasonography; vulvar cancer.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma
  • Feasibility Studies
  • Female
  • Humans
  • Imaging, Three-Dimensional / methods*
  • Middle Aged
  • Pilot Projects
  • Prospective Studies
  • Sentinel Lymph Node / diagnostic imaging*
  • Sentinel Lymph Node / pathology
  • Sentinel Lymph Node Biopsy / methods
  • Single Photon Emission Computed Tomography Computed Tomography / methods*
  • Ultrasonography / instrumentation*
  • Vulvar Neoplasms / pathology*